By the end of 2006, an estimated 23,000 adults and 15,500 children had received cochlear implants in the United States alone (www.nidcd.nih.gov). The complexity of the system as well as confounding factors such as brain plasticity and changing physiology require that these parameters be continually updated to maximize listening performance and user satisfaction. Updating the parameters of these devices as the user adapts to the system currently requires visits to a clinician which limits the number and scope of updates possible within a fixed time frame. As a solution, design and development of a take-home fitting software system is proposed that will enable implant users to interact with and control their personal set of device parameters. Remote health care systems have been demonstrated to reduce medical costs, increase access to medical care, and increase the quality of care for a variety of chronic or long-term care needs. Similarly, the development of a take-home fitting system for cochlear implants has the potential to benefit a significant portion o the implant community. Currently no such at-home fitting system exists, and it is the development of a home-fitting system that is proposed. The proposed system will provide several methods to aid parameter selection as well as a variety of methods for evaluating the newly selected parameters. The goal of Specific Aim 1 is to design an interface that subjects find easy and non-intimidating to use. Evaluation techniques will be incorporated such that subjects can record their performance under different parameter settings and over time, and a personal fitting guide will be incorporated to aid users in selecting parameters for optimization. Each feature will be tested for ease of use with implant users as it is added to the system. The goal for Specific Aim 2 is to determine whether the entire software package as a whole is also easy and effective for improving speech recognition and patient satisfaction in cochlear implant users. The prototype software will be tested at Duke where questions and issues can be cataloged, and subjects will have access to experienced personnel. Subjects will participate in multiple sessions such that they can adjust parameters, experience the result of the parameter adjustments outside of the lab, and return to make further changes based on their experiences. Speech recognition with the clinically-selected and subject-selected parameter values will be measured at the end of each session. Subjects will also be surveyed regarding their opinions on the utility and ease of use of the software. PUBLIC HEALTH RELEVANCE: Cochlear implants are a viable means of restoring hearing to deafened individuals, but tuning the parameters of these devices as the user adapts to the system requires repeat visits to a clinician, limiting the number and scope of updates possible within a fixed time frame. As a solution, we propose to develop a take-home fitting software system that will enable implant users to interact with and control their personal set of device parameter settings. Currently, there is no at-home fitting system available to cochlear implantees so such a home-tuning system could potentially improve both listening performance and satisfaction for a large number of individuals with cochlear implants.